FOUR key areas of patient care are in need of urgent attention after a warts-and-all investigation into the borough's hospital services.

Fairfield Hospital was inspected by the Commission for Health Improvement (CHI) as acute services provided by Bury Health Care NHS Trust were put under scrutiny.

The CHI verdict was revealed in a 55-page report unveiled this week.

It comes nine months after 13 hospital doctors wrote to the Bury Times to publicly apologise for their "sense of failure" in serving the population of Bury, pointing out the low morale among staff.

An action plan to improve patient care is now being drawn up by Trust bosses after the CHI highlighted four areas of concern. They are:

that hospital staff are "stretched to the limit";

that there is a breakdown in communication between the Trust and/or between staff;

that there should be more involvement in the planning of patient services;

that the Trust has significantly higher death rates within 30 days of emergency surgery than the national average. But the CHI review also revealed several examples of good practice. Singled out for praise was the dedicated and hard-working staff committed to patient care, leadership that aims to provide quality care under difficult circumstances, and waiting lists and times which are lower than the national average .

In fact, the Trust's performance in five out of seven categories was not significantly different from the average nationally.

The CHI spent four days at Fairfield in September, interviewing 127 patients, carers, GPs and members of the public.

They found that overall staffing levels are lower than in similar Trusts and this was was to be a great concern for patients and staff who were worried about its effect on care. However, the report also noted that medical staff were "dedicated".

The number of complaints received by the Trust over the previous four years had risen from 143 in 1997-98 to 237 in 2000-01 with more than 60 per cent relating to medical and clinical aspects.

But at the same time staff were said to be trained in customer care and advised patients to complain if they were not satisfied.

The majority of patients told the CHI they had had a poor experience when accessing services provided by the Trust.

Although there were good examples of departments involving patients in planning care, the CHI also noted that there was no co-ordinated strategy.

The Trust had expressed a desire to provide quality patient care and services, an aspiration handicapped by a lack of funds, but the CHI stressed that urgent action must be taken to improve communication with, and between, staff to ensure that departments work more effectively.

Currently, the CHI found, there was a gap between how the Trust executive wanted teams to function and how they were actually working.

Chief executive of Bury Health Care NHS Trust, Mr Philip Bacon, commented:

"The report is very positive and the issues pointed out were what we knew already, especially the staffing levels. This report is a way forward. It will lend weight to our arguments that more resources are needed here."